Yesterday Secretary of Health and Human Services Alex Azar used his emergency powers to override the restrictions that 22 states place on pharmacists vaccinating children over age 3.
As I noted in a previous post, a dangerous side effect of the COVID-19 pandemic is that many parents have not been bringing their children to the doctor’s office for their scheduled vaccinations. There are multiple contributing causes. In some cases, parents may be concerned about the expense. In others, they may be concerned that they or their children may get exposed to the virus. The timing of certain immunizations in children can be crucial and, for that reason, pediatricians and primary care practitioners have taken steps to provide immunizations in a safe, socially‐distanced environment.
Despite an encouraging report from the Centers for Disease Control and Prevention that, as COVID-19 cases have declined in New York City, childhood vaccinations have increased, a rebound in vaccinations has not yet been detected in other parts of the country.
Pharmacists receive training and certification to perform immunizations in the course of their education. As far back as the late 1800s, pharmacists assisted physicians with smallpox vaccinations. While it wasn’t always this way, today all 50 states plus the District of Columbia and Puerto Rico allow licensed pharmacists to vaccinate patients. Some states require patients to hand the pharmacist a doctor’s prescription before they can be immunized. Twenty‐two states don’t allow pharmacists to perform many vaccinations on children over age three, and three states—Connecticut, Florida, and Vermont— prohibit pharmacists from vaccinating any children.
Most pharmacists do not receive training to perform immunizations on children below age 3, and Azar’s emergency order only applies to children above that age.
Unsurprisingly, the American Academy of Pediatrics believes the emergency action is unnecessary while the American Pharmacists Association welcomed it.
The COVID-19 pandemic provides a lesson in how health care practitioner “scope of practice” laws don’t let health care professionals practice to the full extent of their training and thus restrict patients’ choice and access to health care.
While he should have done it sooner, Secretary Azar was right to issue this emergency order. State lawmakers should see this as an opportunity to permanently expand pharmacists’ legal scope of practice.